Tuesday, October 23, 2012

World Health Organization Urges Countries to Ban Electronic Cigarettes Because They "Normalize" Smoking

In a 2012 World Health Organization (WHO) report on electronic cigarettes from the Conference of Parties to the Framework Convention on Tobacco Control, WHO is urging countries to ban these products because they "normalize" smoking.

According to the report: "ENDS [electronic cigarettes] are products resembling cigarettes and could therefore undermine the denormalization of tobacco use upheld by the WHO FCTC. One of the guiding principles of the guidelines for implementation of Article 12 (Education, communication, training and public awareness) is Norm change. It stipulates that it is “essential to change social, environmental and cultural norms and perceptions regarding the acceptability of the consumption of tobacco products, exposure to tobacco smoke ...”. Parties are therefore invited to consider that a ban of ENDS as already undertaken by some Parties would contribute to changing the social norms regarding the consumption of tobacco products."

It should be noted that the WHO's advice on electronic cigarettes has a significant influence on many countries' regulatory decisions on electronic cigarettes. For example, Qatar recently announced a ban on electronic cigarettes and cited the WHO's recommendations as a major factor in its decision.

The Rest of the Story

The World Health Organization is arguing that electronic cigarettes should be banned because their use "normalizes" smoking and that a ban on these products would result in the "de-normalization" of smoking.

What a bunch of crap.

What does the World Health Organization think that smokers who are using electronic cigarettes are going to do if these products are taken off the market? Quit smoking? Not likely. The truth is that if taken off the market, most ex-smokers who have quit by using electronic cigarettes are going to return to cigarette smoking. Thus, a ban on these products will not have any effect on reducing smoking and therefore will not contribute in any way to the de-normalization of smoking.

Moreover, smokers who are using electronic cigarettes are typically those who are unable to quit. If not for electronic cigarettes, they would be smoking, not ex-smokers. Thus, the use of electronic cigarettes plays no role in normalizing smoking behavior. On the contrary, it helps many smokers get off of cigarettes and thus reduces smoking prevalence.

What the World Health Organization is saying is that electronic cigarette use is unacceptable because it "looks like" smoking. The WHO is willing to let this ideological obsession outweigh the tremendous potential for public health benefits and the saving of lives that electronic cigarettes offer.

In other words, the World Health Organization is telling countries that it is more important to discourage any behavior that looks like smoking than it is to save the lives of smokers. Better that smokers should die than that they should adopt a behavior that looks like smoking, even though that behavior may well save their lives.

This is such a dreadful and irresponsible position that it leads me to question whether the Framework Convention on Tobacco Control may end up doing more harm than good. If this is what FCTC is all about, then I'm not convinced that its adoption is going to end up benefiting the public's health.

By its position on electronic cigarettes, the World "Health" Organization is sacrificing health for the sake of a narrow ideology. Its "quit or die" attitude for smokers demonstrates a callous disregard for the lives and health of smokers. The lives and health of smokers are apparently not very important to WHO because those lives can be sacrificed for the principle that there is nothing worse than a behavior that mimics smoking.

Of course, what the WHO fails to recognize is that the fact that vaping mimics smoking is precisely the reason why electronic cigarettes are such a promising strategy for smoking cessation. They are the first product in history that addresses both the pharmacologic and the behavioral aspects of smoking addiction.

The rest of the story is that the World Health Organization is not only making a completely fallacious argument by suggesting that electronic cigarettes normalize smoking. The WHO is also demonstrating that it has lost its vision of its health mission and is now willing to sacrifice the lives of smokers for the sake of an ill-conceived ideology.

About Me

Dr. Siegel is a Professor in the Department of Community Health Sciences, Boston University School of Public Health. He has 25 years of experience in the field of tobacco control. He previously spent two years working at the Office on Smoking and Health at CDC, where he conducted research on secondhand smoke and cigarette advertising. He has published nearly 70 papers related to tobacco. He testified in the landmark Engle lawsuit against the tobacco companies, which resulted in an unprecedented $145 billion verdict against the industry. He teaches social and behavioral sciences, mass communication and public health, and public health advocacy in the Masters of Public Health program.